In the Tanglou, after Professor Huang and Lai Meiyun had a pre-operative communication, the operation officially started half an hour later.

Anesthesiologist Qian Zhe performed tracheal intubation and general anesthesia on Lai Meiyun, and placed her in a supine position with her legs spread.

Tanglou took a pen and made an incision mark 2cm below Lai Meiyun's delicate navel. In order to cooperate with the operation, the navel was obviously cleaned carefully.

I don't know if I used too much force, but some of them were white and rosy.

Looking at Lai Meiyun's white, tender and flat belly, it would be a waste of resources to leave an ugly scar.

"Veress needle puncture..."

Lin Dong acted as an assistant and performed the puncture.

"Carbon dioxide, pressure maintained at 12 mm Hg..."

Due to the single-channel method, there is also precise control of the air pressure.

Listen to Tanglou's step-by-step controller's surgical procedure.

Professor Huang and Director Cheng, who were guiding on the side, nodded slightly.

"Scalpel..."

After Tang Lou took the scalpel, he directly chose the pen-holding method and used the open method to incise the peritoneum through the abdominal linea alba to prepare for the insertion channel.

The whole movement is smooth and fast.

Looking at the incision technology in Tanglou's tiny operating space, Professor Huang praised Director Cheng: "Xiao Tang's basic skills are very good."

Incision is an essential skill for every surgeon. It can be said to be simple or difficult, but being able to do it so accurately and smoothly is very skillful.

Especially for such a young man.

"X-E single channel system ready..."

Soon the equipment nurse brought over the X-E single-channel entrance system that had been prepared.

Although he had heard Tang Qichen introduce it many times before and had seen surgery videos, it was the first time for Cheng Jian to see live operations.

The X-E single-channel entrance system is composed of 2 pieces of metal and rubber sleeves.

The incision is only about 2cm, so after the operation is completed, it can be minimally invasive, which is very suitable for idols like Lai Meiyun who rely on their bodies and faces to make a living.

The establishment of the entire single-channel entrance system is very simple. After hooking the two metal sheaths on the abdominal wall and merging them, a rubber sleeve is put on to complete the establishment of the single-channel surgical entrance system.

The rubber sleeve is composed of four 5mm operation holes and one 12mm operation hole. The 12mm operation hole can be converted into a 5mm operation hole by inserting a matching converter. It is also equipped with a bleed component to reduce smoke interference.

The rubber sleeve has a relatively large degree of mobility, and combined with the pre-curved grasping forceps and the endoscope with a length of 50 mm and a diameter of 5.5 mm, it can effectively reduce the mutual interference of the instruments and improve the success rate of the operation.

At the same time, the X-E single-hole entrance system can be reused multiple times after disinfection without additional medical expenses.

"The X-E single-channel entrance system is very convenient and practical, and it has truly improved the success rate of surgery."

Professor Huang has personally operated dozens of surgeries and has a deep understanding of it. He sincerely hopes to popularize it, which is one of the reasons why he is willing to participate in this surgery.

Cheng Jian nodded slightly. The innovation of surgical techniques is closely related to the advancement of medical equipment. Of course, the most important thing is the operator.

The combination of advanced technology and a talented healer can often burst out with endless energy.

In front of the operating table, after completing the establishment of the single channel, Tanglou slightly adjusted the patient's position to a head-high-foot-low position.

Next is the first step to dissect the gallbladder triangle.

I saw Tanglou very delicately using curved forceps to pull the bottom of the gallbladder cephalad. The next step is a very critical step, identifying Rouviere's sulcus.

Rouviere's sulcus is the only visible landmark on the surface of the right liver and was first proposed by French anatomist Rouviere in 1924.

During the development of hepatobiliary surgery, with the deepening understanding of the anatomy of Rouviere's sulcus, it was realized that cutting the cystic duct above the level of Rouviere's sulcus can effectively avoid extrahepatic bile duct injury.

Therefore, when dissecting the gallbladder triangle, the Rouviere sulcus will be identified first, and this will be used as a basis to determine the safe triangle area.

On the screen, under the fine anatomy of the tenement building, the convergence point was clearly revealed, and the safety triangle was quickly found following the Rouviere ditch.

"Xiao Tang, you have a very deep understanding of the anatomy of Rouviere's sulcus."

Professor Huang praised again.

"Really quite skilled."

Cheng Jian replied lightly, but he was very happy in his heart. It was rare for Professor Huang to like such a skilled practitioner.

Tanglou was already quietly operating there attentively. After confirming the safety triangle, he directly opened the retroperitoneum downwards and then separated the gallbladder fossa upwards and backwards.

"The movements are well controlled and the mentality is very stable. I am not greedy for too much and stray away from other structures."

Professor Huang continued to comment, the more I see Tanglou, the more I like it. Many doctors will go to this step and go to extravagant measures to simultaneously dissociate other structures. It seems very neat, but it is easy to accidentally injure the portal duct structure.

"Separating pliers..."

With talent and concentration, Tanglou was completely immersed in the operation. After dissecting the posterior and anterior triangles of the gallbladder, he started to use dissecting forceps to dissect the cystic artery and cystic duct without stopping.

"Ultrasonic scalpel..."

Another instruction was given calmly.

The instrument nurse immediately handed over the instruments.

"It is quite decisive to directly cut off the cystic artery with an ultrasonic scalpel."

Professor Huang looked at the steps of Tanglou on the screen and was very happy. He did not expect that the operation at Hecheng No. 1 Hospital was not completed this time, but he received an even bigger surprise.

The next step is to peel off the gallbladder. On the screen, the curved forceps controlled by Tang Lou are pulling the bottom of the gallbladder in the upper left direction.

Start peeling off the gallbladder from the right side of the gallbladder bed. It is obviously a single-channel operating hole, which gives the Tanglou a relaxed feeling of opening the abdomen.

Especially after operating continuously for such a long time, instead of feeling tired, I feel more and more energetic.

"Xiao Tang's concentration and energy are very good. He is really suitable for being in the operating room."

Professor Huang has taught too many interns and residents, and even some trainees from municipal hospitals who were former chief physicians. He has such a vicious vision.

"Tanglou is a well-known physical monster in our hospital."

Cheng Jian said quietly to the side, after all, he had suffered a lot from it.

On the screen, Tang Lou continued to control the curved forceps to clamp the round ligament of the liver toward the head and peel it off from the left side of the gallbladder bed.

After the left and right sides join together, continue the dissection toward the porta hepatis.

At this step, more than half of the process has been completed. The next step is to reconfirm the relationship between the cystic duct and the common bile duct. As long as there are no problems, the proximal end of the cystic duct can be directly clamped. After the ultrasonic scalpel is severed, the gallbladder can be removed.

Cheng Jian breathed a sigh of relief. Professor Huang still had some unfinished thoughts.

However, Tang Lou's hand on the screen suddenly stopped.

"What's going on?"

Cheng Jian was a little surprised.

Professor Huang also looked at the screen and saw that the camera stopped at the cystic duct and the neck of the gallbladder.

"The cystic duct and common hepatic duct are too long..."

"Incarcerated stones in the neck of the gallbladder cause hepatic duct stenosis..."

Professor Huang's eyesight was so amazing that he immediately saw the clues. Cheng Jian on the side also reacted, and the two of them almost blurted out at the same time:
Chapter completed!